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ON WRIT OF CERTIORARI TO THE UNITED STATES
COURT OFAPPEALS FOR THE NINTH CIRCUIT

[June 6, 2005]

Justice Stevens
delivered the opinion of the Court.

California is one of at least nine
States that authorize the use of marijuana for medicinal
purposes.1 The
question presented in this case is whether the power vested in
Congress by Article I, §8, of the Constitution [t]o
make all Laws which shall be necessary and proper for carrying
into Execution its authority to regulate Commerce
with foreign Nations, and among the several States
includes the power to prohibit the local cultivation and use of
marijuana in compliance with California law.

I

California has been a pioneer in the
regulation of marijuana. In 1913, California was one of the
first States to prohibit the sale and possession of
marijuana,2 and
at the end of the century, California became the first State to
authorize limited use of the drug for medicinal purposes. In
1996, California voters passed Proposition 215, now codified as
the Compassionate Use Act of 1996.3 The proposition was designed
to ensure that seriously ill residents of the State
have access to marijuana for medical purposes, and to encourage
Federal and State Governments to take steps towards ensuring
the safe and affordable distribution of the drug to patients in
need.4 The Act
creates an exemption from criminal prosecution for
physicians,5 as
well as for patients and primary caregivers who possess or
cultivate marijuana for medicinal purposes with the
recommendation or approval of a physician.6 A primary
caregiver is a person who has consistently assumed
responsibility for the housing, health, or safety of the
patient.7

Respondents Angel Raich and Diane
Monson are California residents who suffer from a variety of
serious medical conditions and have sought to avail themselves
of medical marijuana pursuant to the terms of the Compassionate
Use Act. They are being treated by licensed, board-certified
family practitioners, who have concluded, after prescribing a
host of conventional medicines to treat respondents
conditions and to alleviate their associated symptoms, that
marijuana is the only drug available that provides effective
treatment. Both women have been using marijuana as a
medication for several years pursuant to their doctors
recommendation, and both rely heavily on cannabis to function
on a daily basis. Indeed, Raichs physician believes that
forgoing cannabis treatments would certainly cause Raich
excruciating pain and could very well prove fatal.

Respondent Monson cultivates her own
marijuana, and ingests the drug in a variety of ways including
smoking and using a vaporizer. Respondent Raich, by contrast,
is unable to cultivate her own, and thus relies on two
caregivers, litigating as John Does, to provide her
with locally grown marijuana at no charge. These caregivers
also process the cannabis into hashish or keif, and Raich
herself processes some of the marijuana into oils, balms, and
foods for consumption.

On August 15, 2002, county deputy
sheriffs and agents from the federal Drug Enforcement
Administration (DEA) came to Monsons home. After a
thorough investigation, the county officials concluded that her
use of marijuana was entirely lawful as a matter of California
law. Nevertheless, after a 3-hour standoff, the federal agents
seized and destroyed all six of her cannabis plants.

Respondents thereafter brought this
action against the Attorney General of the United States and
the head of the DEA seeking injunctive and declaratory relief
prohibiting the enforcement of the federal Controlled
Substances Act (CSA), 84 Stat. 1242, 21 U.S.C. § 801et seq., to the extent it prevents them from possessing,
obtaining, or manufacturing cannabis for their personal medical
use. In their complaint and supporting affidavits, Raich and
Monson described the severity of their afflictions, their
repeatedly futile attempts to obtain relief with conventional
medications, and the opinions of their doctors concerning their
need to use marijuana. Respondents claimed that enforcing the
CSA against them would violate the Commerce Clause, the Due
Process Clause of the Fifth Amendment, the
Ninth and Tenth
Amendments of the Constitution, and the doctrine of medical
necessity.

The District Court denied
respondents motion for a preliminary injunction.
Raich v. Ashcroft, 248 F. Supp. 2d 918 (ND
Cal. 2003). Although the court found that the federal
enforcement interests wane[d] when compared to the
harm that California residents would suffer if denied access to
medically necessary marijuana, it concluded that respondents
could not demonstrate a likelihood of success on the merits of
their legal claims. Id., at 931.

A divided panel of the Court of
Appeals for the Ninth Circuit reversed and ordered the District
Court to enter a preliminary injunction.8Raich v.
Ashcroft, 352 F.3d 1222 (2003). The court found that
respondents had demonstrated a strong likelihood of
success on their claim that, as applied to them, the CSA is an
unconstitutional exercise of Congress Commerce Clause
authority. Id., at 1227. The Court of Appeals
distinguished prior Circuit cases upholding the CSA in the face
of Commerce Clause challenges by focusing on what it deemed to
be the separate and distinct class of
activities at issue in this case: the
intrastate, noncommercial cultivation and possession of
cannabis for personal medical purposes as recommended by a
patients physician pursuant to valid California state
law. Id., at 1228. The court found the latter
class of activities different in kind from drug
trafficking because interposing a physicians
recommendation raises different health and safety concerns, and
because this limited use is clearly distinct from the
broader illicit drug marketas well as any broader
commercial market for medicinal marijuanainsofar as the
medicinal marijuana at issue in this case is not intended for,
nor does it enter, the stream of commerce.
Ibid.

The majority placed heavy reliance on
our decisions in United States v. Lopez,514 U.S. 549 (1995),
and United States v. Morrison, 529 U.S. 598 (2000),
as interpreted by recent Circuit precedent, to hold that this
separate class of purely local activities was beyond the reach
of federal power. In contrast, the dissenting judge concluded
that the CSA, as applied to respondents, was clearly valid
under Lopez and Morrison; moreover, he thought it
simply impossible to distinguish the relevant conduct
surrounding the cultivation and use of the marijuana crop at
issue in this case from the cultivation and use of the wheat
crop that affected interstate commerce in Wickard v.
Filburn. 352 F.3d,at 1235 (Beam, J.,
dissenting) (citation omitted).

The obvious importance of the case
prompted our grant of certiorari. 542 U.S. 936 (2004).
The case is made difficult by respondents strong
arguments that they will suffer irreparable harm because,
despite a congressional finding to the contrary, marijuana does
have valid therapeutic purposes. The question before us,
however, is not whether it is wise to enforce the statute in
these circumstances; rather, it is whether Congress power
to regulate interstate markets for medicinal substances
encompasses the portions of those markets that are supplied
with drugs produced and consumed locally. Well-settled law
controls our answer. The CSA is a valid exercise of federal
power, even as applied to the troubling facts of this case. We
accordingly vacate the judgment of the Court of Appeals.

II

Shortly after taking office in 1969,
President Nixon declared a national war on drugs.9 As the first
campaign of that war, Congress set out to enact legislation
that would consolidate various drug laws on the books into a
comprehensive statute, provide meaningful regulation over
legitimate sources of drugs to prevent diversion into illegal
channels, and strengthen law enforcement tools against the
traffic in illicit drugs.10 That effort culminated in the passage of
the Comprehensive Drug Abuse Prevention and Control Act of
1970, 84 Stat. 1236.

This was not, however, Congress
first attempt to regulate the national market in drugs.
Rather, as early as 1906 Congress enacted federal legislation
imposing labeling regulations on medications and prohibiting
the manufacture or shipment of any adulterated or misbranded
drug traveling in interstate commerce.11 Aside from these labeling
restrictions, most domestic drug regulations prior to 1970
generally came in the guise of revenue laws, with the
Department of the Treasury serving as the Federal
Governments primary enforcer.12 For example, the primary
drug control law, before being repealed by the passage of the
CSA, was the Harrison Narcotics Act of 1914, 38 Stat. 785
(repealed 1970). The Harrison Act sought to exert control over
the possession and sale of narcotics, specifically cocaine and
opiates, by requiring producers, distributors, and purchasers
to register with the Federal Government, by assessing taxes
against parties so registered, and by regulating the issuance
of prescriptions.13

Marijuana itself was not
significantly regulated by the Federal Government until 1937
when accounts of marijuanas addictive qualities and
physiological effects, paired with dissatisfaction with
enforcement efforts at state and local levels, prompted
Congress to pass the Marihuana Tax Act, Pub. L. 75238, 50
Stat. 551 (repealed 1970).14 Like the Harrison Act, the Marihuana Tax
Act did not outlaw the possession or sale of marijuana
outright. Rather, it imposed registration and reporting
requirements for all individuals importing, producing, selling,
or dealing in marijuana, and required the payment of annual
taxes in addition to transfer taxes whenever the drug changed
hands.15
Moreover, doctors wishing to prescribe marijuana for medical
purposes were required to comply with rather burdensome
administrative requirements.16 Noncompliance exposed traffickers to
severe federal penalties, whereas compliance would often
subject them to prosecution under state law.17 Thus, while the Marihuana
Tax Act did not declare the drug illegal per se, the
onerous administrative requirements, the prohibitively
expensive taxes, and the risks attendant on compliance
practically curtailed the marijuana trade.

Then in 1970, after declaration of
the national war on drugs, federal drug policy
underwent a significant transformation. A number of noteworthy
events precipitated this policy shift. First, in Leary
v. United States,395 U.S. 6 (1969), this
Court held certain provisions of the Marihuana Tax Act and
other narcotics legislation unconstitutional. Second, at the
end of his term, President Johnson fundamentally reorganized
the federal drug control agencies. The Bureau of Narcotics,
then housed in the Department of Treasury, merged with the
Bureau of Drug Abuse Control, then housed in the Department of
Health, Education, and Welfare (HEW), to create the Bureau of
Narcotics and Dangerous Drugs, currently housed in the
Department of Justice.18 Finally, prompted by a perceived need to
consolidate the growing number of piecemeal drug laws and to
enhance federal drug enforcement powers, Congress enacted the
Comprehensive Drug Abuse Prevention and Control Act.19

Title II of that Act, the CSA,
repealed most of the earlier antidrug laws in favor of a
comprehensive regime to combat the international and interstate
traffic in illicit drugs. The main objectives of the CSA were
to conquer drug abuse and to control the legitimate and
illegitimate traffic in controlled substances.20 Congress was particularly
concerned with the need to prevent the diversion of drugs from
legitimate to illicit channels.21

To effectuate these goals, Congress
devised a closed regulatory system making it unlawful to
manufacture, distribute, dispense, or possess any controlled
substance except in a manner authorized by the CSA. 21 U.S.C. §
841(a)(1), 844(a). The CSA categorizes all controlled
substances into five schedules. §812. The drugs are
grouped together based on their accepted medical uses, the
potential for abuse, and their psychological and physical
effects on the body. §§811, 812.Each
schedule is associated with a distinct set of controls
regarding the manufacture, distribution, and use of the
substances listed therein. §§821830. The CSA
and its implementing regulations set forth strict requirements
regarding registration, labeling and packaging, production
quotas, drug security, and recordkeeping. Ibid. 21 CFR
§1301 et seq. (2004).

In enacting the CSA, Congress
classified marijuana as a Schedule I drug. 21 U.S.C. §
812(c). This preliminary classification was based, in
part, on the recommendation of the Assistant Secretary of HEW
that marihuana be retained within schedule I at least
until the completion of certain studies now underway.22 Schedule I
drugs are categorized as such because of their high potential
for abuse, lack of any accepted medical use, and absence of any
accepted safety for use in medically supervised treatment.
§812(b)(1). These three factors, in varying gradations,
are also used to categorize drugs in the other four schedules.
For example, Schedule II substances also have a high potential
for abuse which may lead to severe psychological or physical
dependence, but unlike Schedule I drugs, they have a currently
accepted medical use. §812(b)(2). By classifying
marijuana as a Schedule I drug, as opposed to listing it on a
lesser schedule, the manufacture, distribution, or possession
of marijuana became a criminal offense, with the sole exception
being use of the drug as part of a Food and Drug Administration
pre-approved research study. §§823(f), 841(a)(1),
844(a); see also United States v. Oakland Cannabis
Buyers Cooperative, 532 U.S. 483, 490
(2001).

The CSA provides for the periodic
updating of schedules and delegates authority to the Attorney
General, after consultation with the Secretary of Health and
Human Services, to add, remove, or transfer substances to,
from, or between schedules. §811. Despite considerable
efforts to reschedule marijuana, it remains a Schedule I
drug.23

III

Respondents in this case do not
dispute that passage of the CSA, as part of the Comprehensive
Drug Abuse Prevention and Control Act, was well within
Congress commerce power. Brief for Respondents 22, 38.
Nor do they contend that any provision or section of the CSA
amounts to an unconstitutional exercise of congressional
authority. Rather, respondents challenge is actually
quite limited; they argue that the CSAs categorical
prohibition of the manufacture and possession of marijuana as
applied to the intrastate manufacture and possession of
marijuana for medical purposes pursuant to California law
exceeds Congress authority under the Commerce Clause.

In assessing the validity of
congressional regulation, none of our Commerce Clause cases can
be viewed in isolation. As charted in considerable detail in
United States v. Lopez, our understanding of the
reach of the Commerce Clause, as well as Congress
assertion of authority thereunder, has evolved over time.24 The Commerce
Clause emerged as the Framers response to the central
problem giving rise to the Constitution itself: the absence of
any federal commerce power under the Articles of
Confederation.25 For the first century of our history, the
primary use of the Clause was to preclude the kind of
discriminatory state legislation that had once been
permissible.26 Then, in response to rapid industrial
development and an increasingly interdependent national
economy, Congress ushered in a new era of federal
regulation under the commerce power, beginning with the
enactment of the Interstate Commerce Act in 1887, 24 Stat. 379,
and the Sherman Antitrust Act in 1890, 26 Stat. 209, as
amended, 15 U.S.C.
§ 2 et seq.27

Cases decided during that new
era, which now spans more than a century, have identified
three general categories of regulation in which Congress is
authorized to engage under its commerce power. First, Congress
can regulate the channels of interstate commerce. Perez
v. United States,402 U.S. 146, 150
(1971). Second, Congress has authority to regulate and protect
the instrumentalities of interstate commerce, and persons or
things in interstate commerce. Ibid. Third, Congress
has the power to regulate activities that substantially affect
interstate commerce. Ibid.;NLRB v.
Jones & Laughlin Steel Corp.,301 U.S. 1, 37 (1937).
Only the third category is implicated in the case at hand.

Our case law firmly establishes
Congress power to regulate purely local activities that
are part of an economic class of activities that
have a substantial effect on interstate commerce. See,
e.g., Perez, 402 U.S., at 151; Wickard v.
Filburn, 317
U.S. 111, 128129 (1942). As we stated in
Wickard, even if appellees activity be local
and though it may not be regarded as commerce, it may still,
whatever its nature, be reached by Congress if it exerts a
substantial economic effect on interstate commerce.
Id., at 125. We have never required Congress to
legislate with scientific exactitude. When Congress decides
that the total
incidence of a
practice poses a threat to a national market, it may regulate
the entire class. See Perez, 402 U.S., at 154155
(quoting Westfall v. United States, 274 U.S. 256, 259
(1927)([W]hen it is necessary in order to prevent
an evil to make the law embrace more than the precise thing to
be prevented it may do so)). In this vein, we have
reiterated that when a
general regulatory statute bears a substantial relation to
commerce, the de minimis character of individual
instances arising under that statute is of no
consequence.
E.g.,Lopez, 514 U.S., at 558 (emphasis deleted)
(quoting Maryland v. Wirtz, 392 U.S. 183, 196,
n. 27 (1968)).

Our decision in Wickard,317 U.S. 111, is of
particular relevance. In Wickard, we upheld the
application of regulations promulgated under the Agricultural
Adjustment Act of 1938, 52 Stat. 31, which were designed to
control the volume of wheat moving in interstate and foreign
commerce in order to avoid surpluses and consequent abnormally
low prices. The regulations established an allotment of 11.1
acres for Filburns 1941 wheat crop, but he sowed 23
acres, intending to use the excess by consuming it on his own
farm. Filburn argued that even though we had sustained
Congress power to regulate the production of goods for
commerce, that power did not authorize federal regulation
[of] production not intended in any part for commerce but
wholly for consumption on the farm. Wickard, 317
U.S., at 118. Justice Jacksons opinion for a unanimous
Court rejected this submission. He wrote:

The effect of the statute before us is to restrict the
amount which may be produced for market and the extent as well
to which one may forestall resort to the market by producing to
meet his own needs. That appellees own contribution to
the demand for wheat may be trivial by itself is not enough to
remove him from the scope of federal regulation where, as here,
his contribution, taken together with that of many others
similarly situated, is far from trivial. Id., at
127128.

Wickard thus establishes that Congress can regulate
purely intrastate activity that is not itself
commercial, in that it is not produced for sale, if
it concludes that failure to regulate that class of activity
would undercut the regulation of the interstate market in that
commodity.

The similarities between this case
and Wickard are striking. Like the farmer in
Wickard, respondents are cultivating, for home
consumption, a fungible commodity for which there is an
established, albeit illegal, interstate market.28 Just as the
Agricultural Adjustment Act was designed to control the
volume [of wheat] moving in interstate and foreign commerce in
order to avoid surpluses  and consequently control
the market price, id., at 115, a primary purpose of the
CSA is to control the supply and demand of controlled
substances in both lawful and unlawful drug markets. See
nn. 2021, supra. In Wickard, we had
no difficulty concluding that Congress had a rational basis for
believing that, when viewed in the aggregate, leaving
home-consumed wheat outside the regulatory scheme would have a
substantial influence on price and market conditions. Here
too, Congress had a rational basis for concluding that leaving
home-consumed marijuana outside federal control would similarly
affect price and market conditions.

More concretely, one concern
prompting inclusion of wheat grown for home consumption in the
1938 Act was that rising market prices could draw such wheat
into the interstate market, resulting in lower market prices.
Wickard, 317 U.S., at 128. The parallel concern making
it appropriate to include marijuana grown for home consumption
in the CSA is the likelihood that the high demand in the
interstate market will draw such marijuana into that market.
While the diversion of homegrown wheat tended to frustrate the
federal interest in stabilizing prices by regulating the volume
of commercial transactions in the interstate market, the
diversion of homegrown marijuana tends to frustrate the federal
interest in eliminating commercial transactions in the
interstate market in their entirety. In both cases, the
regulation is squarely within Congress commerce power
because production of the commodity meant for home consumption,
be it wheat or marijuana, has a substantial effect on supply
and demand in the national market for that commodity.29

Nonetheless, respondents suggest that
Wickard differs from this case in three respects: (1)
the Agricultural Adjustment Act, unlike the CSA, exempted small
farming operations; (2) Wickard involved a
quintessential economic activitya commercial
farmwhereas respondents do not sell marijuana; and (3)
the Wickard record made it clear that the aggregate
production of wheat for use on farms had a significant impact
on market prices. Those differences, though factually
accurate, do not diminish the precedential force of this
Courts reasoning.

The fact that Wickards own
impact on the market was trivial by itself was not a sufficient reason for
removing him from the scope of federal regulation. 317 U.S.,
at 127. That the Secretary of Agriculture elected to exempt
even smaller farms from regulation does not speak to his power
to regulate all those whose aggregated production was
significant, nor did that fact play any role in the
Courts analysis. Moreover, even though Wickard was
indeed a commercial farmer, the activity he was engaged
inthe cultivation of wheat for home consumptionwas
not treated by the Court as part of his commercial farming
operation.30
And while it is true that the record in the Wickard case
itself established the causal connection between the production
for local use and the national market, we have before us
findings by Congress to the same effect.

Findings in the introductory sections
of the CSA explain why Congress deemed it appropriate to
encompass local activities within the scope of the CSA. See
n. 20, supra. The submissions of the parties and
the numerous amici all seem to agree that the national,
and international, market for marijuana has dimensions that are
fully comparable to those defining the class of activities
regulated by the Secretary pursuant to the 1938 statute.31 Respondents
nonetheless insist that the CSA cannot be constitutionally
applied to their activities because Congress did not make a
specific finding that the intrastate cultivation and possession
of marijuana for medical purposes based on the recommendation
of a physician would substantially affect the larger interstate
marijuana market. Be that as it may, we have never required
Congress to make particularized findings in order to legislate,
see Lopez, 514 U.S., at 562; Perez, 402 U.S., at
156, absent a special concern such as the protection of free
speech, see, e.g.,Turner Broadcasting System, Inc.
v. FCC, 512
U.S. 622, 664668 (1994) (plurality opinion). While
congressional findings are certainly helpful in reviewing the
substance of a congressional statutory scheme, particularly
when the connection to commerce is not self-evident, and while
we will consider congressional findings in our analysis when
they are available, the absence of particularized findings does
not call into question Congress authority to legislate.32

In assessing the scope of
Congress authority under the Commerce Clause, we stress
that the task before us is a modest one. We need not determine
whether respondents activities, taken in the aggregate,
substantially affect interstate commerce in fact, but only
whether a rational basis exists for so concluding.
Lopez, 514 U.S., at 557; see also Hodel v.
Virginia Surface Mining & Reclamation Assn., Inc.,452 U.S. 264,
276280 (1981); Perez, 402 U.S., at 155156;
Katzenbach v. McClung, 379 U.S. 294,
299301 (1964); Heart of Atlanta Motel, Inc. v.
United States, 379 U.S. 241,
252253 (1964). Given the enforcement difficulties that
attend distinguishing between marijuana cultivated locally and
marijuana grown elsewhere, 21 U.S.C. §
801(5), and concerns about diversion into illicit
channels,33
we have no difficulty concluding that Congress had a rational
basis for believing that failure to regulate the intrastate
manufacture and possession of marijuana would leave a gaping
hole in the CSA. Thus, as in Wickard, when it enacted
comprehensive legislation to regulate the interstate market in
a fungible commodity, Congress was acting well within its
authority to make all Laws which shall be necessary and
proper to regulate Commerce among the
several States. U.S. Const., Art. I, §8. That the
regulation ensnares some purely intrastate activity is of no
moment. As we have done many times before, we refuse to excise
individual components of that larger scheme.

IV

To support their contrary submission,
respondents rely heavily on two of our more recent Commerce
Clause cases. In their myopic focus, they overlook the larger
context of modern-era Commerce Clause jurisprudence preserved
by those cases. Moreover, even in the narrow prism of
respondents creation, they read those cases far too
broadly. Those two cases, of course,
are Lopez, 514
U.S. 549,and Morrison, 529 U.S. 598. As an
initial matter, the statutory challenges at issue in those
cases were markedly different from the challenge respondents
pursue in the case at hand. Here, respondents ask us to excise
individual applications of a concededly valid statutory scheme.
In contrast, in both Lopez and Morrison, the
parties asserted that a particular statute or provision fell
outside Congress commerce power in its entirety. This
distinction is pivotal for we have often reiterated that
[w]here the class of activities is regulated and that
class is within the reach of federal power, the courts have no
power to excise, as trivial, individual instances
of the class. Perez, 402 U.S., at 154 (emphasis
deleted)(quoting Wirtz, 392 U.S., at 193); see
also Hodel, 452 U.S., at 308.

At issue in Lopez, 514 U.S. 549, was the
validity of the Gun-Free School Zones Act of 1990, which was a
brief, single-subject statute making it a crime for an
individual to possess a gun in a school zone. 104 Stat.
48444845, 18
U.S.C. § 922(q)(1)(A). The Act did not regulate any
economic activity and did not contain any requirement that the
possession of a gun have any connection to past interstate
activity or a predictable impact on future commercial activity.
Distinguishing our earlier cases holding that comprehensive
regulatory statutes may be validly applied to local conduct
that does not, when viewed in isolation, have a significant
impact on interstate commerce, we held the statute invalid. We
explained:

Section 922(q) is a criminal statute that by its terms
has nothing to do with commerce or any sort of
economic enterprise, however broadly one might define those
terms. Section 922(q) is not an essential part of a larger
regulation of economic activity, in which the regulatory scheme
could be undercut unless the intrastate activity were
regulated. It cannot, therefore, be sustained under our cases
upholding regulations of activities that arise out of or are
connected with a commercial transaction, which viewed in the
aggregate, substantially affects interstate commerce.
514 U.S., at 561.

The statutory scheme that the
Government is defending in this litigation is at the opposite
end of the regulatory spectrum. As explained above, the CSA,
enacted in 1970 as part of the Comprehensive Drug Abuse
Prevention and Control Act, 84 Stat. 12421284, was a
lengthy and detailed statute creating a comprehensive framework
for regulating the production, distribution, and possession of
five classes of controlled substances. Most of
those substancesthose listed in Schedules II through
Vhave a useful and legitimate medical purpose and
are necessary to maintain the health and general welfare of the
American people. 21 U.S.C. §
801(1). The regulatory scheme is designed to foster the
beneficial use of those medications, to prevent their misuse,
and to prohibit entirely the possession or use of substances
listed in Schedule I, except as a part of a strictly controlled
research project.

While the statute provided for the
periodic updating of the five schedules, Congress itself made
the initial classifications. It identified 42 opiates, 22
opium derivatives, and 17 hallucinogenic substances as Schedule
I drugs. 84 Stat. 1248. Marijuana was listed as the 10th item
in the third subcategory. That classification, unlike the
discrete prohibition established by the Gun-Free School Zones
Act of 1990, was merely one of many essential part[s] of
a larger regulation of economic activity, in which the
regulatory scheme could be undercut unless the intrastate
activity were regulated. Lopez, 514 U.S., at
561.34 Our
opinion in Lopez casts no doubt on the validity of such
a program.

Nor does this Courts holding in
Morrison, 529
U.S. 598. The Violence Against Women Act of 1994, 108
Stat. 1902, created a federal civil remedy for the victims of
gender-motivated crimes of violence. 42 U.S.C. §
13981. The remedy was enforceable in both state and
federal courts, and generally depended on proof of the
violation of a state law. Despite congressional findings that
such crimes had an adverse impact on interstate commerce, we
held the statute unconstitutional because, like the statute in
Lopez, it did not regulate economic activity. We
concluded that the noneconomic, criminal nature of the
conduct at issue was central to our decision in
Lopez, and that our prior cases had identified a clear
pattern of analysis: Where economic activity substantially affects
interstate commerce, legislation regulating that activity will
be sustained.35Morrison, 529 U.S., at 610.

Unlike those at issue in Lopez
and Morrison, the activities regulated by the CSA
are quintessentially economic. Economics refers to
the production, distribution, and consumption of
commodities. Websters Third New International
Dictionary 720 (1966). The CSA is a statute that regulates the
production, distribution, and consumption of commodities for
which there is an established, and lucrative, interstate
market. Prohibiting the intrastate possession or manufacture
of an article of commerce is a rational (and commonly utilized)
means of regulating commerce in that product.36 Such prohibitions include
specific decisions requiring that a drug be withdrawn from the
market as a result of the failure to comply with regulatory
requirements as well as decisions excluding Schedule I drugs
entirely from the market. Because the CSA is a statute that
directly regulates economic, commercial activity, our opinion
in Morrison casts no doubt on its constitutionality.

The Court of Appeals was able to
conclude otherwise only by isolating a separate and
distinct class of activities that it held to be beyond
the reach of federal power, defined as the intrastate,
noncommercial cultivation, possession and use of marijuana for
personal medical purposes on the advice of a physician and in
accordance with state law. 352 F.3d, at 1229. The court
characterized this class as different in kind from drug
trafficking. Id., at 1228. The differences
between the members of a class so defined and the principal
traffickers in Schedule I substances might be sufficient to
justify a policy decision exempting the narrower class from the
coverage of the CSA. The question, however, is whether
Congress contrary policy judgment, i.e., its
decision to include this narrower class of
activities within the larger regulatory scheme, was
constitutionally deficient. We have no difficulty concluding
that Congress acted rationally in determining that none of the
characteristics making up the purported class, whether viewed
individually or in the aggregate, compelled an exemption from
the CSA; rather, the subdivided class of activities defined by
the Court of Appeals was an essential part of the larger
regulatory scheme.

First, the fact that marijuana is
used for personal medical purposes on the advice of a
physician cannot itself serve as a distinguishing factor.
352 F.3d, at 1229. The CSA designates marijuana as contraband
for any purpose; in fact, by characterizing marijuana as
a Schedule I drug, Congress expressly found that the drug has
no acceptable medical uses. Moreover, the CSA is a
comprehensive regulatory regime specifically designed to
regulate which controlled substances can be utilized for
medicinal purposes, and in what manner. Indeed, most of the
substances classified in the CSA have a useful and
legitimate medical purpose. 21 U.S.C. §
801(1). Thus, even if respondents are correct that
marijuana does have accepted medical uses and thus should be
redesignated as a lesser schedule drug,37 the CSA would still impose
controls beyond what is required by California law. The CSA
requires manufacturers, physicians, pharmacies, and other
handlers of controlled substances to comply with statutory and
regulatory provisions mandating registration with the DEA,
compliance with specific production quotas, security controls
to guard against diversion, recordkeeping and reporting
obligations, and prescription requirements. See 21 U.S.C. §
821830; 21 CFR §1301 et seq. (2004).
Furthermore, the dispensing of new drugs, even when doctors
approve their use, must await federal approval. United
States v. Rutherford, 442 U.S. 544 (1979).
Accordingly, the mere fact that marijuanalike virtually
every other controlled substance regulated by the CSAis
used for medicinal purposes cannot possibly serve to
distinguish it from the core activities regulated by the CSA.

Nor can it serve as an
objective marke[r] or objective
facto[r] to arbitrarily narrow the relevant class as the
dissenters suggest, post, at 6 (OConnor, J.,
dissenting); post, at 12 (Thomas, J., dissenting). More
fundamentally, if, as the principal dissent contends, the
personal cultivation, possession, and use of marijuana for
medicinal purposes is beyond the  outer
limits of Congress Commerce Clause authority,
post, at 1 (OConnor, J., dissenting), it must also
be true that such personal use of marijuana (or any other
homegrown drug) for recreational purposes is also beyond those
 outer limits,  whether or
not a State elects to authorize or even regulate such use.
Justice Thomas separate dissent suffers from the same
sweeping implications. That is, the dissenters rationale
logically extends to place any federal regulation
(including quality, prescription, or quantity controls) of
any locally cultivated and possessed controlled
substance for any purpose beyond the
 outer limits  of
Congress Commerce Clause authority. One need not have a
degree in economics to understand why a nationwide exemption
for the vast quantity of marijuana (or other drugs) locally
cultivated for personal use (which presumably would include use
by friends, neighbors, and family members) may have a
substantial impact on the interstate market for this
extraordinarily popular substance. The congressional judgment
that an exemption for such a significant segment of the total
market would undermine the orderly enforcement of the entire
regulatory scheme is entitled to a strong presumption of
validity. Indeed, that judgment is not only rational, but
visible to the naked eye, Lopez, 514 U.S.,
at 563, under any commonsense appraisal of the probable
consequences of such an open-ended exemption.

Second, limiting the activity to
marijuana possession and cultivation in accordance with
state law cannot serve to place respondents
activities beyond congressional reach. The Supremacy Clause
unambiguously provides that if there is any conflict between
federal and state law, federal law shall prevail. It is beyond
peradventure that federal power over commerce is
 superior to that of the States to provide for
the welfare or necessities of their
inhabitants,  however legitimate or dire those
necessities may be. Wirtz, 392 U.S., at 196 (quoting
Sanitary Dist. of Chicago v. United States, 266 U.S. 405, 426
(1925)). See also 392 U.S.,at 195196;
Wickard, 317 U.S., at 124 ( [N]o form
of state activity can constitutionally thwart the regulatory
power granted by the commerce clause to
Congress ). Just as state acquiescence to
federal regulation cannot expand the bounds of the Commerce
Clause, see, e.g., Morrison, 529 U.S., at
661662 (Breyer, J., dissenting) (noting that 38 States
requested federal intervention), so too state action cannot
circumscribe Congress plenary commerce power. See
United States v. Darby, 312 U.S. 100, 114
(1941) (That power can neither be enlarged nor diminished
by the exercise or non-exercise of state power).38

Respondents acknowledge this
proposition, but nonetheless contend that their activities were
not an essential part of a larger regulatory scheme
because they had been isolated by the State of
California, and [are] policed by the State of California,
and thus remain entirely separated from the market.
Tr. of Oral Arg. 27. The dissenters fall prey to similar
reasoning. See n. 38, supra this page. The notion that
California law has surgically excised a discrete activity that
is hermetically sealed off from the larger interstate marijuana
market is a dubious proposition, and, more importantly, one
that Congress could have rationally rejected.

Indeed, that the California
exemptions will have a significant impact on both the supply
and demand sides of the market for marijuana is not just
plausible as the principal dissent concedes,
post, at 16 (OConnor, J., dissenting), it is
readily apparent. The exemption for physicians provides them
with an economic incentive to grant their patients permission
to use the drug. In contrast to most prescriptions for legal
drugs, which limit the dosage and duration of the usage, under
California law the doctors permission to recommend
marijuana use is open-ended. The authority to grant permission
whenever the doctor determines that a patient is afflicted with
any other illness for which marijuana provides
relief, Cal. Health & Safety Code Ann.
§11362.5(b)(1)(A) (West Supp. 2005), is broad enough to
allow even the most scrupulous doctor to conclude that some
recreational uses would be therapeutic.39 And our cases have taught
us that there are some unscrupulous physicians who
overprescribe when it is sufficiently profitable to do so.40

The exemption for cultivation by
patients and caregivers can only increase the supply of
marijuana in the California market.41 The likelihood that all
such production will promptly terminate when patients recover
or will precisely match the patients medical needs during
their convalescence seems remote; whereas the danger that
excesses will satisfy some of the admittedly enormous demand
for recreational use seems obvious.42 Moreover, that the national
and international narcotics trade has thrived in the face of
vigorous criminal enforcement efforts suggests that no small
number of unscrupulous people will make use of the California
exemptions to serve their commercial ends whenever it is
feasible to do so.43 Taking into account the fact that
California is only one of at least nine States to have
authorized the medical use of marijuana, a fact Justice
OConnors dissent conveniently disregards in arguing
that the demonstrated effect on commerce while admittedly
plausible is ultimately
unsubstantiated, post, at 14, 16, Congress
could have rationally concluded that the aggregate impact on
the national market of all the transactions exempted from
federal supervision is unquestionably substantial.

So, from the separate and
distinct class of activities identified by the Court of
Appeals (and adopted by the dissenters), we are left with
the intrastate, noncommercial cultivation, possession and
use of marijuana. 352 F.3d, at 1229. Thus the case for
the exemption comes down to the claim that a locally cultivated
product that is used domestically rather than sold on the open
market is not subject to federal regulation. Given the
findings in the CSA and the undisputed magnitude of the
commercial market for marijuana, our decisions in
Wickard v. Filburn and the later cases endorsing
its reasoning foreclose that claim.

V

Respondents also raise a substantive
due process claim and seek to avail themselves of the medical
necessity defense. These theories of relief were set forth in
their complaint but were not reached by the Court of Appeals.
We therefore do not address the question whether judicial
relief is available to respondents on these alternative bases.
We do note, however, the presence of another avenue of relief.
As the Solicitor General confirmed during oral argument, the
statute authorizes procedures for the reclassification of
Schedule I drugs. But perhaps even more important than these
legal avenues is the democratic process, in which the voices of
voters allied with these respondents may one day be heard in
the halls of Congress. Under the present state of the law,
however, the judgment of the Court of Appeals must be vacated.
The case is remanded for further proceedings consistent with
this opinion.

4. The people of the State of
California hereby find and declare that the purposes of the
Compassionate Use Act of 1996 are as follows:
(A) To ensure that seriously ill
Californians have the right to obtain and use marijuana for
medical purposes where that medical use is deemed appropriate
and has been recommended by a physician who has determined that
the persons health would benefit from the use of
marijuana in the treatment of cancer, anorexia, AIDS, chronic
pain, spasticity, glaucoma, arthritis, migraine, or any other
illness for which marijuana provides relief.
(B) To ensure that patients and
their primary caregivers who obtain and use marijuana for
medical purposes upon the recommendation of a physician are not
subject to criminal prosecution or sanction.
(C) To encourage the federal and
state governments to implement a plan to provide for the safe
and affordable distribution of marijuana to all patients in
medical need of marijuana. §11362.5(b)(1) (West
Supp. 2005).

5. Notwithstanding any other
provision of law, no physician in this state shall be punished,
or denied any right or privilege, for having recommended
marijuana to a patient for medical purposes.
§11362.5(c) (West Supp. 2005).

6. Section 11357, relating to the
possession of marijuana, and Section 11358, relating to the
cultivation of marijuana, shall not apply to a patient, or to a
patients primary caregiver, who possesses or cultivates
marijuana for the personal medical purposes of the patient upon
the written or oral recommendation or approval of a
physician. §11362.5(d) (West Supp. 2005).

8. On remand, the District Court entered a
preliminary injunction enjoining petitioners
 from arresting or prosecuting Plaintiffs
Angel McClary Raich and Diane Monson, seizing their medical
cannabis, forfeiting their property, or seeking civil or
administrative sanctions against them with respect to the
intrastate, non-commercial cultivation, possession, use, and
obtaining without charge of cannabis for personal medical
purposes on the advice of a physician and in accordance with
state law, and which is not used for distribution, sale, or
exchange.  Brief for Petitioners 9.

14. R. Bonnie & C. Whitebread, The
Marijuana Conviction 154174 (1999); L. Grinspoon & J.
Bakalar, Marihuana, the Forbidden Medicine 78 (rev. ed.
1997) (hereinafter Grinspoon & Bakalar). Although this was the
Federal Governments first attempt to regulate the
marijuana trade, by this time all States had in place some form
of legislation regulating the sale, use, or possession of
marijuana. R. Isralowitz, Drug Use, Policy, and Management 134
(2d ed. 2002).

19. The Comprehensive Drug Abuse
Prevention and Control Act of 1970 consists of three titles.
Title I relates to the prevention and treatment of narcotic
addicts through HEW (now the Department of Health and Human
Services). 84 Stat. 1238. Title II, as discussed in more
detail above, addresses drug control and enforcement as
administered by the Attorney General and the DEA. Id.,
at 1242. Title III concerns the import and export of
controlled substances. Id., at 1285.

20. In particular, Congress made the
following findings: (1) Many of
the drugs included within this subchapter have a useful and
legitimate medical purpose and are necessary to maintain the
health and general welfare of the American people.
(2) The illegal importation,
manufacture, distribution, and possession and improper use of
controlled substances have a substantial and detrimental effect
on the health and general welfare of the American people.
(3) A major portion of the
traffic in controlled substances flows through interstate and
foreign commerce. Incidents of the traffic which are not an
integral part of the interstate or foreign flow, such as
manufacture, local distribution, and possession, nonetheless
have a substantial and direct effect upon interstate commerce
because
(A) after
manufacture, many controlled substances are transported in
interstate commerce,
(B)
controlled substances distributed locally usually have been
transported in interstate commerce immediately before their
distribution, and
(C)
controlled substances possessed commonly flow through
interstate commerce immediately prior to such possession.
(4) Local distribution and
possession of controlled substances contribute to swelling the
interstate traffic in such substances.
(5) Controlled substances
manufactured and distributed intrastate cannot be
differentiated from controlled substances manufactured and
distributed interstate. Thus, it is not feasible to
distinguish, in terms of controls, between controlled
substances manufactured and distributed interstate and
controlled substances manufactured and distributed intrastate.
(6) Federal control of the
intrastate incidents of the traffic in controlled substances is
essential to the effective control of the interstate incidents
of such traffic. 21 U.S.C. §
801(1)(6).

21. See United States v.
Moore,423 U.S.
122, 135 (1975); see also H. R. Rep., at 22.

23. Starting in 1972, the National
Organization for the Reform of Marijuana Laws (NORML) began its
campaign to reclassify marijuana. Grinspoon & Bakalar
1317. After some fleeting success in 1988 when an
Administrative Law Judge (ALJ) declared that the DEA would be
acting in an unreasonable, arbitrary, and
capricious manner if it continued to deny marijuana
access to seriously ill patients, and concluded that it should
be reclassified as a Schedule III substance, Grinspoon
v. DEA, 828 F.2d 881, 883884 (CA1 1987), the
campaign has proved unsuccessful. The DEA Administrator did
not endorse the ALJs findings, 54 Fed. Reg. 53767 (1989),
and since that time has routinely denied petitions to
reschedule the drug, most recently in 2001. 66 Fed. Reg. 20038
(2001). The Court of Appeals for the District of Columbia
Circuit has reviewed the petition to reschedule marijuana on
five separate occasions over the course of 30 years, ultimately
upholding the Administrators final order. See
Alliance for Cannabis Therapeutics v. DEA, 15 F.3d
1131, 1133 (1994).

27.Lopez, 514 U.S., at 554; see
also Wickard v. Filburn, 317 U.S. 111, 121
(1942) (It was not until 1887, with the enactment of the
Interstate Commerce Act, that the interstate commerce power
began to exert positive influence in American law and life.
This first important federal resort to the commerce power was
followed in 1890 by the Sherman Anti-Trust Act and, thereafter,
mainly after 1903, by many others. These statutes ushered in
new phases of adjudication, which required the Court to
approach the interpretation of the Commerce Clause in the light
of an actual exercise by Congress of its power thereunder
(footnotes omitted)).

28. Even respondents acknowledge the
existence of an illicit market in marijuana; indeed, Raich has
personally participated in that market, and Monson expresses a
willingness to do so in the future. App. 59, 74, 87. See also
Department of Revenue of Mont. v. Kurth Ranch, 511 U.S. 767, 770,
774, n. 12, and 780, n. 17 (1994) (discussing the
market value of marijuana); id., at 790
(Rehnquist, C. J., dissenting); id., at 792
(OConnor, J., dissenting); Whalen v. Roe,
429 U.S. 589, 591
(1977) (addressing prescription drugs for which there is
both a lawful and an unlawful market); Turner v.
United States, 396 U.S. 398, 417,
n. 33 (1970) (referring to the purchase of drugs on the
retail market).

29. To be sure, the wheat market is a
lawful market that Congress sought to protect and stabilize,
whereas the marijuana market is an unlawful market that
Congress sought to eradicate. This difference, however, is of
no constitutional import. It has long been settled that
Congress power to regulate commerce includes the power to
prohibit commerce in a particular commodity. Lopez, 514
U.S., at 571 (Kennedy, J., concurring) (In the Lottery
Case, 188 U.S.
321 (1903), the Court rejected the argument that Congress
lacked [the] power to prohibit the interstate movement of
lottery tickets because it had power only to regulate, not to
prohibit); see also Wickard, 317 U.S., at 128
(The stimulation of commerce is a use of the regulatory
function quite as definitely as prohibitions or restrictions
thereon).

30. See Wickard, 317 U.S.,at 125 (recognizing that Wickards activity may
not be regarded as commerce).

31. The Executive Office of the President
has estimated that in 2000 American users spent $10.5
billion on the purchase of marijuana. Office of Nat.
Drug Control Policy, Marijuana Fact Sheet 5 (Feb. 2004),
available at
http://www.whitehousedrugpolicy.gov/publications/factsht/mariju
ana/index.html (all Internet materials as visited June 2, 2005,
and available in Clerk of Courts case file).

32. Moreover, as discussed in more detail
above, Congress did make findings regarding the effects of
intrastate drug activity on interstate commerce. See
n. 20, supra. Indeed, even the Court of Appeals
found that those findings weigh[ed] in favor of
upholding the constitutionality of the CSA. 352 F.3d 1222,
1232 (CA9 2003) (case below). The dissenters, however, would
impose a new and heightened burden on Congress (unless the
litigants can garner evidence sufficient to cure Congress
perceived inadequa[cies])that legislation
must contain detailed findings proving that each activity
regulated within a comprehensive statute is essential to the
statutory scheme. Post, at 1315 (OConnor,
J., dissenting); post, at 8 (Thomas, J., dissenting).
Such an exacting requirement is not only unprecedented, it is
also impractical. Indeed, the principal dissents
critique of Congress for not even including
declarations specific to marijuana is particularly
unpersuasive given that the CSA initially identified 80 other
substances subject to regulation as Schedule I drugs, not to
mention those categorized in Schedules IIV. Post,
at 14 (OConnor, J., dissenting). Surely, Congress
cannot be expected (and certainly should not be required) to
include specific findings on each and every substance contained
therein in order to satisfy the dissenters unfounded
skepticism.

33. See n. 21, supra (citing
sources that evince Congress particular concern with the
diversion of drugs from legitimate to illicit channels).

34. The principal dissent asserts that by
[s]eizing upon our language in Lopez,
post, at 5 (opinion of OConnor, J.), i.e.,
giving effect to our well-established case law, Congress
will now have an incentive to legislate broadly. Even putting
aside the political checks that would generally curb
Congress power to enact a broad and comprehensive scheme
for the purpose of targeting purely local activity, there is no
suggestion that the CSA constitutes the type of
evasive legislation the dissent fears, nor could
such an argument plausibly be made. Post, at 6
(OConnor, J., dissenting).

35.Lopez, 514 U.S., at 560; see
also id., at 573574 (Kennedy, J., concurring)
(stating that Lopez did not alter our practical
conception of commercial regulation and that Congress may
regulate in the commercial sphere on the assumption that
we have a single market and a unified purpose to build a stable
national economy).

37. We acknowledge that evidence
proffered by respondents in this case regarding the effective
medical uses for marijuana, if found credible after trial,
would cast serious doubt on the accuracy of the findings that
require marijuana to be listed in Schedule I. See,
e.g., Institute of Medicine, Marijuana and Medicine:
Assessing the Science Base 179 (J. Joy, S. Watson, & J. Benson
eds. 1999) (recognizing that [s]cientific data indicate
the potential therapeutic value of cannabinoid drugs, primarily
THC [Tetrahydrocannabinol] for pain relief, control of nausea
and vomiting, and appetite stimulation); see also
Conant v. Walters, 309 F.3d 629, 640643 (CA9
2002) (Kozinski, J., concurring) (chronicling medical studies
recognizing valid medical uses for marijuana and its
derivatives). But the possibility that the drug may be
reclassified in the future has no relevance to the question
whether Congress now has the power to regulate its production
and distribution. Respondents submission, if accepted,
would place all homegrown medical substances beyond the reach
of Congress regulatory jurisdiction.

38. That is so even if Californias
current controls (enacted eight years after the Compassionate
Use Act was passed) are [e]ffective, as the
dissenters would have us blindly presume, post, at 15
(OConnor, J., dissenting); post, at 6, 12 (Thomas,
J., dissenting). Californias decision (made 34 years
after the CSA was enacted) to impose stric[t]
controls on the cultivation and possession of
marijuana for medical purposes, post, at 6
(Thomas, J., dissenting), cannot retroactively divest Congress
of its authority under the Commerce Clause. Indeed, Justice
Thomas urgings to the contrary would turn the Supremacy
Clause on its head, and would resurrect limits on congressional
power that have long since been rejected. See post, at
8 (Scalia, J., concurring in judgment) (quoting
McCulloch v. Maryland, 4 Wheat. 316, 424 (1819))
( To impose on [Congress] the necessity of
resorting to means which it cannot control, which another
government may furnish or withhold, would render its course
precarious, the result of its measures uncertain, and create a
dependence on other governments, which might disappoint its
most important designs, and is incompatible with the language
of the constitution ). Moreover, in
addition to casting aside more than a century of this
Courts Commerce Clause jurisprudence, it is noteworthy
that Justice Thomas suggestion that States possess the
power to dictate the extent of Congress commerce power
would have far-reaching implications beyond the facts of this
case. For example, under his reasoning, Congress would be
equally powerless to regulate, let alone prohibit, the
intrastate possession, cultivation, and use of marijuana for
recreational purposes, an activity which all States
strictly contro[l]. Indeed, his rationale
seemingly would require Congress to cede its constitutional
power to regulate commerce whenever a State opts to exercise
its traditional police powers to define the criminal law
and to protect the health, safety, and welfare of their
citizens. Post, at 910 (dissenting
opinion).

39. Californias Compassionate Use
Act has since been amended, limiting the catchall category to
[a]ny other chronic or persistent medical symptom that
either: [s]ubstantially limits the ability of the person
to conduct one or more major life activities as defined
in the Americans with Disabilities Act of 1990, or [i]f
not alleviated, may cause serious harm to the patients
safety or physical or mental health. Cal. Health & Safety
Code Ann. §§11362.7(h)(12)(A) to (12)(B) (West Supp.
2005).

41. The state policy allows patients to
possess up to eight ounces of dried marijuana, and to cultivate
up to 6 mature or 12 immature plants. Cal. Health & Safety
Code Ann. §11362.77(a) (West Supp. 2005). However, the
quantity limitations serve only as a floor. Based on a
doctors recommendation, a patient can possess whatever
quantity is necessary to satisfy his medical needs, and cities
and counties are given carte blanche to establish more
generous limits. Indeed, several cities and counties have done
just that. For example, patients residing in the cities of
Oakland and Santa Cruz and in the counties of Sonoma and Tehama
are permitted to possess up to 3 pounds of processed marijuana.
Reply Brief for United States 19 (citing Proposition 215
Enforcement Guidelines). Putting that quantity in perspective,
3 pounds of marijuana yields roughly 3,000 joints or
cigarettes. Executive Office of the President, Office of
National Drug Control Policy, What Americas Users Spend
on Illegal Drugs 24 (Dec. 2001),
http://www.whitehousedrugpolicy.gov/publications/pdf/american_u
sers_spend_2002.pdf. And the street price for that amount can
range anywhere from $900 to $24,000. DEA, Illegal Drug Price
and Purity Report (Apr. 2003) (DEA02058).

42. For example, respondent Raich attests
that she uses 2.5 ounces of cannabis a week. App. 82. Yet as
a resident of Oakland, she is entitled to possess up to 3
pounds of processed marijuana at any given time, nearly 20
times more than she uses on a weekly basis.

43. See, e.g.,People ex rel.
Lungren v. Peron, 59 Cal. App. 4th 1383,
13861387 (1997) (recounting how a Cannabis Buyers
Club engaged in an indiscriminate and uncontrolled
pattern of sale to thousands of persons among the general
public, including persons who had not demonstrated any
recommendation or approval of a physician and, in fact, some of
whom were not under the care of a physician, such as undercover
officers, and noting that some persons who had
purchased marijuana on respondents premises were
reselling it unlawfully on the street).